Abstract:
Packing of tympanic cavity is generally considered an essential step in myringoplasty. However, each packing material comes with one or another side effect. The objective of this meta-analysis was to compare the results of Type 1 myringoplasty with or without packing. Pubmed, Cochrane database, Embase, Google Scholar, and clinicaltrials.gov were searched using \'tympanoplasty or myringoplasty and packing\' as the search query. All RCTs / quasi-RCTs comparing tympanoplasty Type 1 with packing (control) versus without packing (intervention) of tympanic cavity in the human population were included. For dichotomous and continuous outcomes, relative risks (RR) and mean differences (MD) were calculated with 95% confidence interval, respectively. Heterogeneity was assessed using I2 statistics. Publication bias was checked using funnel plot and Egger\'s test, if applicable. Quality of evidence was assessed for each outcome using GRADE approach. Eleven studies were deemed eligible. For graft uptake and functional success rate, RR of 1.01 and 1.05 were obtained, respectively, showing no significant differences between the intervention and control groups. At 1st and 3rd postoperative month, no-packing group showed 3.86 dB and 2.08 dB better air-bone gap (ABG) closure than the packing group, respectively. Also, intervention with no-packing was 9.28-minute shorter procedure. With RR 0.35, no-packing had significantly lesser postoperative aural fullness. Type 1 tympanoplasty performed with or without packing show comparable results in terms of graft uptake and functional success rate. However, if performed without packing, it takes shorter time, provides early hearing improvement and causes less aural fullness. Key Words: Tympanoplasty Type 1, Packing, Gelfoam, No-packing, Meta-analysis, Endoscopic myringoplasty.
摘要:
鼓室的填充通常被认为是鼓膜成形术中的重要步骤。然而,每个包装材料都有一个或另一个副作用。这项荟萃分析的目的是比较有或没有填塞的1型鼓膜成形术的结果。Pubmed,Cochrane数据库,Embase,谷歌学者,和clinicaltrials.gov使用“鼓室成形术或鼓膜成形术和填塞”作为搜索查询。包括所有RCTs/准RCTs,这些RCTs比较了人群中鼓室腔的1型鼓室成形术(对照)与无鼓室充填(干预)。对于二分法和连续的结果,用95%置信区间计算相对风险(RR)和平均差异(MD),分别。使用I2统计学评估异质性。使用漏斗图和Egger检验检查发布偏差,如果适用。使用GRADE方法评估每个结果的证据质量。11项研究被认为是合格的。对于移植物吸收和功能成功率,获得1.01和1.05的RR,分别,干预组和对照组之间没有显着差异。术后1个月和3个月,无包装组比包装组好3.86dB和2.08dB的气-骨间隙(ABG)闭合,分别。此外,无包装的干预措施缩短了9.28分钟。RR为0.35时,无包装的术后听觉饱满度明显降低。在有或没有填塞的情况下进行的1型鼓室成形术在移植物摄取和功能成功率方面显示出可比的结果。然而,如果在没有包装的情况下执行,它需要更短的时间,提供早期听力改善,并导致较少的听觉丰满。关键词:鼓室成形术1型,包装,明胶海绵,无包装,Meta分析,内镜下鼓膜成形术。